Status of neonates delivered by elective Caesarean section

A series of 144 elective Caesarean sections is reported. One hundred and five patients had no evidence of placental dysfunction (group A), of whom 57 (40 with vertex presentation) received extradural analgesia. The remaining 39 patients comprised group B. The uterine incision to delivery (U-D) interval was little influenced by presentation, but was longer with extradural block. Among group A patients Apgar-minus-colour scores and the time to sustained respiration after general anaesthesia were poorer than after extradural analgesia, breech presenting infants being prominent in this regard. The contrast was marked when the U-D interval was relatively prolonged. When the U-D interval was less than 90 s the infants born under extradural analgesia were marginally more acidotic than those born under general anaesthesia; in the latter there was a correlation between the duration of the U-D interval and neonatal acidosis, a feature which was not evident in the extradural series. The small numbers of group B cases precluded statistical evaluation, but the results reflected contrasts similar to those found among group A patients.